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Closure of a Patent Foramen Ovale (PFO): An Intervention Sequence
Published on: December 23, 2022
Does a patent foramen ovale influence cognitive function in dialysis patients?
Sudhakar George1, Stephen Holt, Nick Medford
1Clinical Investigations and Research Unit, Brighton and Sussex University Hospitals, Brighton, UK. sudhakargeorge@gmail.com
Nephron. Clinical Practice
|June 6, 2013
Summary
Cognitive decline is common in dialysis patients. While a patent foramen ovale (PFO) is a potential factor, it showed minimal impact on cognitive decline over one year in hemodialysis patients.
Area of Science:
- Nephrology
- Neurology
- Cardiology
Background:
- Patients undergoing dialysis exhibit diminished cognitive function compared to controls.
- Cerebral microembolisation via a patent foramen ovale (PFO) is a suspected cause.
Purpose of the Study:
- To assess cognitive decline in hemodialysis (HD) and peritoneal dialysis (PD) patients.
- To investigate the influence of PFO on cognitive decline in dialysis patients.
Main Methods:
- Cognitive testing performed on HD and PD patients.
- Transthoracic echocardiography used to detect PFO.
- One-year follow-up to compare cognitive changes based on PFO presence and dialysis type.
Main Results:
- 80 patients (51 HD, 29 PD) were studied; 21% had a PFO.
- 83% of patients experienced cognitive decline over one year.
- PD patients showed faster cognitive decline than HD patients; PFO presence had minor effects.
Conclusions:
- Dialysis patients experience rapid and widespread cognitive decline.
- The impact of PFO on cognitive decline over one year was subtle.
- PFO presence should not deter patients from choosing hemodialysis due to concerns about microembolisation.
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